Incident Reporting

Procedures

Providers are required to submit an incident report for “reportable unusual occurrences” within forty-eight (48) hours of the time of the incident or becoming aware of the incident. Reports of abuse, neglect, or exploitation should be made within twenty-four (24) hours of knowledge of the incident. Incident reports can be completed via the web-based reporting system for non-waiver clients.

Fill Out an Incident Report

If the incident is reported by other than the participant’s case manager, the case manager will be contacted by the DA, as soon as possible. Case managers will identify initial corrective actions needed to address specific situations within one work day. “Reportable unusual occurrence” are considered “Sentinel Incidents” as the participant’s safety, health and welfare may be in jeopardy and include at a minimum the following occurrences listed within IAC 1.2

  1. Alleged, suspected, or actual abuse, neglect or exploitation (A-N-E) of a participant. Please note: contact to local APS is also required
  2. Alleged, suspected, or actual assault or abuse by a participant.
  3. Death of a participant
  4. A residence that compromises the health and safety of a participant due to any of the following :
    • A significant interruption of a major utility.
    • An environmental, structural, or other significant problem.
  5. Environmental or structural problems associated with a dwelling where participants reside that compromise the health and safety of the participants.
  6. A residential fire resulting in any of the following:
    • Relocation.
    • Personal injury.
    • Property loss.
  7. Suspected or observed criminal activity by:
    • Staff member, employee, or agent of a provider;
    • Family member of a participant receiving services; or
    • Participant receiving services; when the care of the participant is impacted or potentially impacted.
  8. Injuries of unknown origin.
  9. Suicidal ideation or a suicide attempt that had the potential to cause physical harm, injury, or death.
  10. A major disturbance or threat to public safety created in the community by the participant.
  11. Admission of a participant to a nursing facility, excluding respite stays.
  12. A significant injury to a participant, including, but not limited to, the following:
    • A fracture.
    • A burn greater than first degree.
    • Choking that requires intervention.
    • Contusions or lacerations.
  13. Police involvement when there is an arrest.
  14. Participant becomes a missing person.
  15. Inadequate staff support for a participant, including inadequate supervision, with the potential for endangering the health or welfare of the participant.

Sentinel Events

Other incidents may be identified as “Sentinel Events,” even though they are not included in the listing above, whenever there is an unexpected occurrence involving serious physical or psychological injury or the risk thereof. Examples of these are:

  • Suspected rape, sexual assault or sexual exploitation against or by a person receiving services.
  • Serious physical harm and/or injury of known or unknown origin to the participant requiring in-patient hospitalization;
  • Participant refuses essential services (such as delivered meals, aide services to monitor health care) that may indicate a significant change in health status
  • Significant change in physical and/or mental health status of the participant